MODULE 1. Interprofessional working in early detection of breast cancer
7. Breast cancer awareness
Importance of the training
Information about the breast cancer is received from different sources, and the information gained from health care professionals is one of the most important ones. Both the professionals working in primary care and in breast screening units play a central role in providing the information for women. It is important that these people have the necessary knowledge about the subject. (Perry – Broeders – de Wolf – Törnberg – Holland – von Karsa 2006, p. 384.)
Beliefs and the behavior of the health professionals may have the major impact on attitudes of the women. Health will improve when health care personnel will play the active role in health education and are a good role model in the society. Health care personnel need to be aware of the breast cancer risks and screening methods, to give guidance to their patients accordingly. |
If patients are aware of the risks, the possibility that they will develop a positive healthy behavior (attendance for breast cancer screenings and performance of breast self-examination regularly) is high. Therefore, the role and the sufficient knowledge of the health professionals are crucial in the process. (Akpınar – Baykan – Naçar – Gün – Çetinkaya 2011.)
Studies have clearly shown, that health care professionals’ knowledge of breast cancer and attitudes towards screening are very important, when they are giving cancer information to patients. If nurses do not have a positive attitude towards screening, how would they be able to pass on accurate and supportive information about screening programs to their patients? (Akpınar Et al. 2011) |
Training programs
The knowledgeable health care professionals teach women about the risks of breast cancer more than healthcare providers who have limited levels of knowledge. Therefore, it is important to provide the knowledge and carry out training among nurses. Educational programs should raise awareness in health care providers rather than increase their knowledge on how to change attitudes and beliefs. The nurses with high awareness of the importance of breast cancer screening and practicing regular breast self-examination are important factors to provide information to women. (Ceber – Turk – Ciceklioglu 2010.)
Nurses are far more numerous in many countries than physicians and nurses are in an ideal position and role to promote health, carry out disease prevention and education. Nurses involved in breast cancer screening have an impact on early detection and share knowledge about breast cancer. Nurses can positively influence the knowledge base, proficiency and frequency of breast self-examination through training. To do so and to be a role model in breast health they need to be well educated and have sufficient knowledge. Well trained nurses are making the difference. (Yarbro 2003.) |
Nurses who are working in primary healthcare are ideal providers of education about breast cancer and early detection practices and thus, it is important to improve their knowledge. Educational programs should be widespread in nursing and midwifery practices and they should be applied to all women. These programs should be designed to enhance nurses and midwifes’ early detection practices, knowledge about the breast cancer, and health beliefs and risks. (Ceber, Et al. 2010)
A Turkish study shows that after one year of education, the trained nurses’ and midwives’ beliefs about breast cancer and screening also changed in a positive manner (Ceber, Et al. 2010). So, it is very important that the healthcare professionals are well trained as female health workers play an important role in screening behaviors by offering positive role models (Akpınar, Et al. 2011). The education should be continuing and include also refresher courses at various intervals. The knowledge should be up to date and improve the quality of the diagnostic process. It is also important to keep records of the trainings as they will be part of the certification review process. (Perry Et al. 2006, p. 357.) |
An example case – Breast cancer Train-the-Trainer program
The World Health Organization has indicated that the cancer education programs are most acutely needed in developing nations. The Train-the-Trainer programs have been considered a very effective way to raise the awareness and the knowledge. (Karayurt – Gürsoy – Taşçı – Gündoğdu 2010.)
In 2003 the first breast cancer Train-the-Trainer (TTT) program was launched in Turkey. The second training was provided in 2005 and the third one in 2008. Total amount of 82 nurses participated and they were given several teaching and learning strategies. The study showed that the participating nurses’ knowledge about breast cancer had increased significantly and the results showed that the training achieved its goal. Trained nurses can help educate women about the importance of breast health and the actions to take to protect themselves against breast cancer. This is only an example of a program that can be easily spread throughout the world. (Karayurt, Et al. 2010.) The content of the TTT training was focused on breast cancer prevention, treatment, symptom management, and the problems of survivors. The program was delivered and publicized at all hospitals and health care centers for nurses who work with breast cancer patients and in early detection. According to the tests before and after the training the knowledge of the participants improved significantly and the nurses were satisfied with the training they received. Nurses identified themselves as having increased confidence, knowledge and awareness of professional issues. (Karayurt, Et al. 2010.) Table 1. Example of the Breast Cancer TTT program in Turkey: Day 1 • Breast cancer patient: case presentation • Breast anatomy and physiology • Breast cancer epidemiology • Etiology of breast cancer and risk factors |
• Prevention and early detection in breast cancer
• Breast cancer symptoms and findings. • Types of breast cancer and staging • Diagnostic procedures of breast cancer and nursing care during these procedures Day 2 • Surgical therapy in breast cancer • Nursing care of patients with breast cancer before and after surgery • Chemotherapy and hormone therapy in breast cancer • Symptom management in chemotherapy and hormone therapy in breast cancer • Radiotherapy in breast cancer • Symptom management in radiotherapy in breast cancer Day 3 • Lymphedema: prevention, signs and symptoms, and care of patients with lymphedema related to breast cancer • Psychosocial problems among breast cancer patients and nursing interventions • Reconstructive surgery in breast cancer • Complementary and alternative therapy in breast cancer • Breast cancer support groups • Experiences of a breast cancer patient (patient’s presentation) • Adult training methods |
Further info
2007 EUSOMA (European Society of Breast Cancer Specialist) has defined the content of the knowledge and training for the health professionals dealing with breast cancer. See the link below:
www.eusoma.org/doc/Guidelines_on_the_standards_for_the_training_of_specialised_health_professionals_dealing_with_breast_cancer.pdf
2007 EUSOMA (European Society of Breast Cancer Specialist) has defined the content of the knowledge and training for the health professionals dealing with breast cancer. See the link below:
www.eusoma.org/doc/Guidelines_on_the_standards_for_the_training_of_specialised_health_professionals_dealing_with_breast_cancer.pdf
Questions
1. How often should training for health care professionals be arranged? Is once a year enough and how would you keep track of who has attended additional training and who has not? Is it possible to keep health care professionals motivated considering frequent training? 2. Do we emphasize the importance of health care professional´s accurate knowledge and the ethical obligation to keep educating themselves after graduation while they are still students? Should we, as health care professionals take a bigger role in setting an example considering breast cancer awareness and spreading it?
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References
- Akpınar, Yeliz Yelen – Baykan, Zeynep – Naçar, Melis – Gün, İskender – Çetinkaya, Fevziye 2011. Knowledge, Attitude about Breast Cancer and Practice of Breast Cancer Screening among Female Health Care. Asian Pacific Journal of Cancer Prevention, Vol 12, 3063-3068
- Ceber, Esin – Turk, Meral – Ciceklioglu, Meltem, 2010. The effects of an educational program on knowledge of breast cancer, early detection practices and health beliefs of nurses and midwives. Journal of Clinical Nursing, 19, 2363–2371 2363. DOI: 10.1111/j.1365-2702.2009.03150.x.
- Karayurt, Özgul – Gürsoy, Ayla Akkaş – Taşçı, Sultan – Gündoğdu, Fatma 2010. Evaluation of the Breast Cancer Train the Trainer Program for Nurses in Turkey. DOI 10.1007/s13187-010-0043-8.
- Perry, N. – Broeders, M. – de Wolf, C. – Törnberg, S. – Holland, R. – von Karsa, L. 2006. European guidelines for quality assurance in breast cancer screening and diagnosis, 4th Edition. Luxembourg: Office for Official Publications of the European Communities.
- Yarbro, Connie Henke 2003. International Nursing and Breast Cancer. USA, The Breast Journal, Volume 9, Suppl. 2, 2003 S98–S100.